Woodstock Nursing Home

Updated 16 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two inspectors and 2 Expert by Experience carried out this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Woodstock Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Woodstock Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 14 March 2023 and ended on 17 March 2023.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR) to help plan our inspection. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also reviewed the information we held about the service. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people who used the service and 14 family members to gain their views of the services provided. We spoke with 10 members of staff which included 2 housekeeping staff, a cook, the maintenance person, activities co-ordinator, nurse, care assistant, an agency member of staff, the registered manager and one of the provider’s regional managers. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We inspected 5 people’s care records and records relating to medicines management. We reviewed various audits plus additional checks and visit reports, used to monitor the safety and quality of the service. We reviewed the service’s continuing improvement plan. We reviewed 3 staff recruitment files and the provider’s staff recruitment and infection control policies.

Updated 16 June 2023

About the service

Woodstock Nursing Home is a residential care home providing personal and nursing care to up to 28 people. The service provides support to people who live with dementia and other associated mental health needs. At the time of our inspection there were 21 people using the service.

Woodstock Nursing Home accommodates people in one adapted building and provides people with a safe garden so they can enjoy the outside.

People’s experience of using this service and what we found

Staff had not been recruited in accordance with the relevant regulation and guidance. The provider’s policy in this respect was not in line with the regulation requirements. Recruitment processes had not been sufficiently checked, to ensure these had been fully completed before staff started work.

It could not always be demonstrated that people were supported to have maximum choice and control of their lives and staff always supported them in the least restrictive way possible and in their best interests. This applied to when equipment was used to monitor people’s movements when in bed or in their bedroom, as part of falls prevention actions. Consent had not always been sought from people or their legal representatives before the use of this equipment. This was rectified during the inspection and people’s representatives were consulted about the equipment in use and relevant records completed.

Deprivation of liberty safeguards had been applied for when people could not consent to live in the care home.

We have made a recommendation that these applications are reviewed to ensure they include any additional areas of supervision and control, such as movement sensor equipment.

Although the provider had quality monitoring systems and processes in place, these had not always been effective in identifying the shortfalls identified during this inspection, which required improvement.

The provider had identified their policies and procedures required review to ensure they were robust and in line with current regulations and best practice guidance.

There were arrangements in place to protect people from abuse.

Risks associated with people’s health and safety were assessed and action taken to reduce and mitigate risks.

Action had been taken to improve the delivery and availability of people’s medicines and to ensure prescribed medicines were available when required. Medicines were administered safely, and people were supported to take their medicines as prescribed.

People’s needs were assessed prior to them moving into the care home and plans of care developed on admission to ensure people’s needs were met. People’s cultural and religious preferences were supported when planning and delivering their care.

People had access to a GP and other health care professionals when required and they were supported to attend external appointments.

Staff were provided with training, so they were able to carry out their tasks safely and improvements to this were planned so that staffs' knowledge could be broadened.

The environment was kept clean and there were arrangements in place to prevent the spread of infection.

There were arrangements in place to gather the views of people who used the service, relatives and staff to support service improvements.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 21 January 2019).

At our last inspection we recommended the service consider current guidance on the Mental Capacity Act (MCA) 2005 and update its practices. At this inspection we found actions taken in response to this had not been maintained.

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection these were rated to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Woodstock Nursing Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to staff recruitment and the provider's quality monitoring systems and processes at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.